Mateen Farrah J, Carone Marco, Tshering Lhab, Dorji Chencho, Dema Ugyen, Grundy Sara J, Pokhrel Dili Ram, Nirola Damber K
Neurological Clinical Research Institute, Department of Neurology, Massachusetts General Hospital, 165 Cambridge St., Boston, MA 02114, USA; Harvard Medical School, 25 Shattuck St., Boston, MA 02114, USA.
Department of Biostatistics, University of Washington, 1705 NE Pacific St., Seattle, WA 98195, USA.
Epilepsy Behav. 2017 Sep;74:76-80. doi: 10.1016/j.yebeh.2017.06.028. Epub 2017 Jul 18.
The objective of this study was to report the impact of chronic abuse of Areca catechu nut wrapped in leaf (also known as doma, quid, paan), the fourth most commonly abused psychoactive substance worldwide, on the frequency of seizures among people with epilepsy.
People with clinically diagnosed epilepsy (>14years old) residing in the Kingdom of Bhutan were surveyed for self-reported Areca catechu use, demographic variables, epilepsy characteristics, and seizure frequency. The relationship between seizure frequency in the prior month and chewing Areca catechu, adjusted for various confounders, was analyzed using multivariable regression models.
There were 152 people with epilepsy, including 50 chewers (33%) and 102 (67%) nonchewers. The median duration of chewing A. catechu was 62months (25th, 75th percentiles: 24, 120months). Chewers consumed an average of three nuts daily. There was no significant difference between chewers and nonchewers in the mean age, proportion of male vs. female, age at first epileptic seizure, or number of antiepileptic drugs presently taken; chewers were more likely to be rural dwellers (p=0.042). After adjustment for all of the above variables, on average, chewers had 58.7% fewer [95%CI: (-79.4, -17.0)] seizures in the prior month, equating to 2.1 fewer [95% CI: (-3.9, -0.3)] seizures.
Our observational study suggests that the social custom of chewing Areca catechu nut is associated with reduced seizure frequency among people with epilepsy. This association may be due to its natural stimulant properties, a novel antiepileptic property of the nut, or has another, yet unknown explanation.
本研究旨在报告全球第四大最常被滥用的精神活性物质——用叶子包裹的槟榔（也称为doma、quid、paan）的长期滥用对癫痫患者癫痫发作频率的影响。
对居住在不丹王国临床诊断为癫痫（>14岁）的人群进行调查，了解其自我报告的槟榔使用情况、人口统计学变量、癫痫特征和癫痫发作频率。使用多变量回归模型分析在前一个月癫痫发作频率与咀嚼槟榔之间的关系，并对各种混杂因素进行了调整。
共有152名癫痫患者，其中50名咀嚼者（33%）和102名非咀嚼者（67%）。咀嚼槟榔的中位时间为62个月（第25、75百分位数：24、120个月）。咀嚼者平均每天食用三颗槟榔。咀嚼者和非咀嚼者在平均年龄、男女比例、首次癫痫发作年龄或目前服用的抗癫痫药物数量方面没有显著差异；咀嚼者更有可能是农村居民（p = 0.042）。在对上述所有变量进行调整后，平均而言，咀嚼者在前一个月的癫痫发作次数减少了58.7%[95%置信区间：（-79.4，-17.0）]，相当于癫痫发作次数减少了2.1次[95%置信区间：（-3.9，-0.3）]。
我们的观察性研究表明，咀嚼槟榔的社会习俗与癫痫患者癫痫发作频率降低有关。这种关联可能是由于其天然的刺激特性、槟榔的一种新的抗癫痫特性，或者有另一种未知的解释。
